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Luis Alberto Ortega-Porcayo,Eibar Ernesto Cabrera-Aldana,Nicasio Arriada-Mendicoa,Juan Luis Gómez-Amador,Martín Granados-García,Juan Barges-Coll 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.6
Anterior exposure for cervical chordomas remains challenging because of the anatomical complexities and the restoration of the dimensional balance of the atlanto-axial region. In this report, we describe and analyze the transmandibular transoral approach and multilevel spinal reconstruction for upper cervical chordomas. We report two cases of cervical chordomas (C2 and C2–C4) that were treated by marginal en bloc resection with a transmandibular approach and anterior-posterior multilevel spinal reconstruction/fixation. Both patients showed clinical improvement. Postoperative imaging was negative for any residual tumor and revealed adequate reconstruction and stabilization. Marginal resection requires more extensive exposure to allow the surgeon access to the entire pathology, as an inadequate tumor margin is the main factor that negatively affects the prognosis. Anterior and posterior reconstruction provides a rigid reconstruction that protects the medulla and decreases axial pain by properly stabilizing the cervical spine.
Juan Luis Gómez-Amador,Cristopher G Valencia-Ramos,Marcos Vinicius Sangrador-Deitos,Aldo Eguiluz-Melendez,Gerardo Y Guinto-Nishimura,Alan Hernández-Hernández,Samuel Romano-Feinholz,Luis Alberto Ortega 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.1
Objective: To describe the roadmapping technique and our three-year experience in the management of intracranial aneurysms in the hybrid operating room. Methods: We analyzed all patients who underwent surgical clipping for cerebral aneurysms with the roadmapping technique from January 2017 to September 2019. We report demographic, clinical, and morphological variables, as well as clinical and radiological outcomes. We further describe three illustrative cases of the technique. Results: A total of 13 patients were included, 9 of which (69.2%) presented with subarachnoid hemorrhage, with a total of 23 treated aneurysms. All patients were female, with a mean age of 47.7 years (range 31-63). All cases were anterior circulation aneurysms, the most frequent location being the ophthalmic segment of the internal carotid artery (ICA) in 11 cases (48%), followed by posterior communicating in 8 (36%), and ICA bifurcation in 2 (8%). Intraoperative clip repositioning was required in 9 aneurysms (36%) as a result of the roadmapping technique in the hybrid operating room. There were no residual aneurysms in our series, nor reported mortality. Conclusions: The roadmapping technique in the hybrid operating room offers a complementary tool for the adequate occlusion of complex intracranial aneurysms, as it provides a real time fluoroscopic-guided clipping technique, and clip repositioning is possible in a single surgical stage, whenever a residual portion of the aneurysm is identified. This technique also provides some advantages, such as immediate vasospasm identification and treatment with intra-arterial vasodilators, balloon proximal control for certain paraclinoid aneurysms, and simultaneous endovascular treatment in selected cases during a single stage. Keywords Aneurysm, Angiography, Complex, Hybrid operating room, Microsurgery, Roadmapping
Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm
Juan Luis Gómez-Amador,Leoncio Alberto Tovar-Romero,Andrea Castillo-Matus,Ricardo Marian-Magaña,Jorge Fernando Aragón-Arreola,Marcos Vinicius Sangrador-Deitos,Alan Hernández-Hernández,Germán López-Val 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.4
Thrombectomy procedures following intra-aneurysmatic lesions are extremely rare, and few cases have been reported. This article describes a microsurgical intra-aneurysmatic thrombectomy (MIaT) for a distal anterior cerebral artery (DACA) aneurysm. We present the case of a 48-year-old female that was admitted to the emergency room, showing neurologic deterioration with focal deficits. A computed tomography angiography (CTA) scan revealed an aneurysm located in the distal segment of the left anterior cerebral artery. During the surgical procedure, after clipping, a wellformed clot was visualized through the aneurysm’s wall obstructing the left DACA flow. We proceeded to open the aneurysm’s dome to remove the thrombus and clip the aneurysm neck, re-establishing the flow of the left DACA.Intra-aneurysmatic thrombosis can occur as a complication during clipping, obstructing the distal flow of vital arteries and causing fatal results in the patient’s postoperative status. MIaT is a good technique for restoring the flow of the affected vessel and allows a secure aneurysm clipping after thrombus removal.
Juan Luis Gómez-Amador,Pablo David Guerrero-Suárez,Jaime Jesús Martínez-Anda,Jorge Fernando Aragón-Arreola,Andrea Castillo-Matus,Ricardo Marian-Magaña,Marcos V Sangrador-Deitos,Alan Hernández-Hernánde 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.4
Bilateral posterior communicating (pComm) artery aneurysms represent only 2% of mirror intracranial aneurysms. Usually, these are surgically approached through bilateral craniotomies for clipping. We present the case of a 50-year-old female presenting with headache and horizontal diplopia. Neurological examination revealed a left oculomotor palsy, with no other neurological deficits. Imaging studies revealed bilateral aneurysmatic lesions in both internal carotid arteries (ICA). A conventional left pterional approach was planned in order to treat the symptomatic aneurysm, and, if deemed feasible, a contralateral clipping through the same approach. The procedure was performed in a hybrid operating room (HOR), performing an intraoperative digital subtraction angiography (DSA) and roadmapping assistance during dissection and clipping. Transoperatively, a post-fixed optic chiasm was identified, with a wide interoptic space, which allowed us to perform the contralateral clipping through a unilateral approach. This technique for clipping bilateral pComm aneurysms can be performed when the proper anatomical features are met.
Gómez-Amador Juan Luis,Sangrador-Deitos Marcos Vinicius,Uribe-Pacheco Rodrigo,Guinto-Nishimura Gerardo Yoshiaki,Mondragón-Soto Michel Gustavo 대한뇌혈관외과학회 2022 Journal of Cerebrovascular and Endovascular Neuros Vol.24 No.1
Posterior Cerebral Artery aneurysms are scarce, yet its territory is frequently associated to large and giant aneurysms. Treatment is mostly a binary option between microsurgical clipping and endovascular coiling. Hybrid approaches are an option too, whereas innovation with less frequent techniques such as endoscope-controlled and endoscope-assisted procedure may provide a safer surgical approach with same successful results. Hereby we report a case of a 53 years old male examined at the ER after presenting generalized seizures and altered state of consciousness. Upon arrival, neurological evaluation revealed homonymous right hemianopia. Computed tomography (CT) scan revealed a subarachnoid hemorrhage and left parieto-occipital intraparenchymal hemorrhage with intraventricular extension; computed tomography angiogram (CTA) revealed an aneurysm at the left posterior cerebral artery (PCA) in its P4 segment. We performed a vascular exploration with drainage of the occipital and intraventricular hematoma through a single endoscopic port through transulcal approach guided by neuronavigation, in addition to clipping and aneurysmectomy. The combination of microsurgical clipping with previous Endoport-guided endoscopic procedure may be a surgical-operative option that not only may facilitate the approach to the desired lesion, but also provides a safer surgical scenario.
Petrochemical effluent treatment using natural coagulants and an aerobic biofilter
Bandala, Erick R.,Tiro, Juan Bernardo,Lujan, Mariana,Camargo, Francisco J.,Sanchez-Salas, Jose Luis,Reyna, Silvia,Moeller, Gabriela,Torres, Luis G. Techno-Press 2013 Advances in environmental research Vol.2 No.3
Coagulation-flocculation (CF) was tested coupled with an aerobic biofilter to reduce total petroleum hydrocarbon (TPHs) concentration and toxicity from petrochemical wastewater. The efficiency of the process was followed using turbidity and chemical oxygen demand (COD). The biofilter was packed with a basaltic waste (tezontle) and inoculated with a bacterial consortium. Toxicity test were carried out using Lactuca sativa var. capitata seeds. Best results for turbidity removal were obtained using alum. Considerable turbidity removal was obtained when using Opuntia spp. COD removal with alum was 25%, for Opuntia powder it was 36%. The application of the biofilter allowed the removal of 70% of the remaining TPHs after 30 days with a biodegradation rate (BDR) value 47 $mgL^{-1}d^{-1}$. COD removal was slightly higher with BDR value 63 $mgL^{-1}d^{-1}$. TPH kinetics allowed a degradation rate constant equal to $4.05{\times}10^{-2}d^{-1}$. COD removal showed similar trend with $k=4.23{\times}10^{-2}d^{-1}$. Toxicity reduction was also successfully achieved by the combined treatment process.
Yeliana L. Sánchez,Manuela Yepes-Calderón,Luis Valbuena,Andrés F. Milán,María C. Trillos-Almanza,Sergio Granados,Miguel Peña,Mauricio Estrada-Castrillón,Juan C. Aristizábal,Raúl Narvez-Sanchez,Jaime G 대한내분비학회 2021 Endocrinology and metabolism Vol.36 No.5
Background: We studied whether musclin function in humans is related to glycemic control, body composition, and cardiorespiratory capacity. Methods: A cross-sectional study was performed in sedentary adults with or without metabolic syndrome (MS). Serum musclin wasmeasured by enzyme-linked immunosorbent assay. Insulin resistance (IR) was evaluated by the homeostatic model assessment(HOMA-IR). Body composition was determined by dual-energy X-ray absorptiometry and muscle composition by measuring carnosine in the thigh, a surrogate of fiber types, through proton magnetic resonance spectroscopy. Cardiorespiratory capacity was assessed through direct ergospirometry. Results: The control (n=29) and MS (n=61) groups were comparable in age (51.5±6.5 years old vs. 50.7±6.1 years old), sex(72.4% vs. 70.5% women), total lean mass (58.5%±7.4% vs. 57.3%±6.8%), and peak oxygen consumption (VO2peak) (31.0±5.8mL O2./kg.min vs. 29.2±6.3 mL O2/kg.min). Individuals with MS had higher body mass index (BMI) (30.6±4.0 kg/m2 vs. 27.4±3.6 kg/m2), HOMA-IR (3.5 [95% confidence interval, CI, 2.9 to 4.6] vs. 1.7 [95% CI, 1.1 to 2.0]), and musclin (206.7 pg/mL [95%CI, 122.7 to 387.8] vs. 111.1 pg/mL [95% CI, 63.2 to 218.5]) values than controls (P˂0.05). Musclin showed a significant relationship with HOMA-IR (β=0.23; 95% CI, 0.12 to 0.33; P˂0.01), but not with VO2peak, in multiple linear regression models adjusted forage, sex, fat mass, lean mass, and physical activity. Musclin was significantly associated with insulin, glycemia, visceral fat, and regional muscle mass, but not with BMI, VCO2peak, maximum heart rate, maximum time of work, or carnosine. Conclusion: In humans, musclin positively correlates with insulinemia, IR, and a body composition profile with high visceral adiposity and lean mass, but low body fat percentage. Musclin is not related to BMI or cardiorespiratory capacity.
Grafting improves salinity tolerance of bell pepper plants during greenhouse production
Blanca E. Orosco-Alcalá,Héctor G. Núñez-Palenius,Fidel Díaz-Serrano,Luis Pérez-Moreno,Mauricio Valencia-Posadas,Libia I. Trejo-Tellez,Nicacio Cruz-Huerta,Juan I. Valiente-Banuet 한국원예학회 2021 Horticulture, Environment, and Biotechnology Vol.62 No.6
Biotic and abiotic stresses aff ect plant growth and productivity. High-salinity stress aff ects crop yield, causing fi nancialloss to growers. The use of salt-tolerant rootstocks is a strategy that has been used to reduce salt damage in crops. A studywas conducted to evaluate the eff ect of salinity-resistant rootstocks on the physiological and morphological characteristicsof bell pepper plants grown under greenhouse conditions. A factorial experiment was conducted using a completely randomizeddesign with two factors. The bell pepper ‘Viper’ cultivar was grafted on two reported salinity-tolerant rootstocks(E21R10144 and E21R10197), and non-grafted (NG) plants were used as the control. Four salinity levels were applied tothe plants (electrical conductivity treatments using NaCl of 2, 4, 6, and 8 dS m −1 ) in Steiner nutritive solution (100%). Theresponse to salinity was determined using morphological and physiological plant parameters, including fruit yield. Increasedtolerance to salinity conditions (NaCl) was observed in the ‘Viper’ bell pepper grafted on E21R10144, which allowed greaterplant height, stem diameter, leaf size, as well as fresh and dry biomass of both the roots and canopy. The impacts on plantphysiological response, including photosynthesis, stomatal conductance, transpiration, water content, stomatal density, andfoliar area, were also determined. Our results indicate that the use of the salinity-tolerant bell pepper rootstock E21R10144maintained plant homeostasis and minimized the damage caused by salts to the morphology and physiology, as well as eff ectson fruit yield; thus, it is a promising tool for the management of salt stress.
김규연 ( Marc Miravitlles ),( Pawel Sliwinski ),( Richard Costello ),( Victoria Carter ),( Jessica Tan ),( Therese Laperre ),( Bernardino Alcazar ),( Caroline Gouder ),( Cristina Esquinas ),( Juan Luis G 대한결핵 및 호흡기학회 2017 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.124 No.-
Background/Aim: Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition requiring therapeutic management to be tailored to the clinical characteristics and disease severity of the individual patient. Due to scarcity of studies about racial differences in COPD patients, in this study, we compared clinical characteristics between Asian and other patients of COPD. Method: This was an international, multicenter, prospective study of a cohort of patients with COPD aimed to validate the concept of clinical control in COPD. We compared two subgroups (Asian versus others) by using clinical criteria, questionnaires (COPD Assessment Test -CAT- or Clinical COPD Questionnaire -CCQ-) and recent concept of control. Results: A total of 349 patients were analysed, 110 (32%) patients were Asian and 239 (68%) patients were others. There was a significant difference at sex, smoking status and BMI between Asian and others. Among clinical characteristics, there was a significant difference at median FEV1 (mL), and percentage of patients who have emphysema between two subgroups. Also, number of exacerbation and hospital admission, median CCQ score and recent concept of Impact (Clinical approach by mMRC, rescue medication, time walked/day and sputum color) were the characteristics which show significant disparities between two subgroups. Conclusion: This study showed significant differences in various factors between Asian and other patients of COPD. These results suggest that therapeutic management of COPD should be tailored to the ethnic group of the individual patients